Lumpectomy then Mastectomy?

Anna, how did your breast cancer present initially? Was it in the form of calcifications?

Here's the thing about calcifications - they are very common - about 50% of women get them - and about 95% of the time, they are benign and harmless. But they also can be a sign of breast cancer.  So if you have calcs that have already been tested and shown to be breast cancer and if the calcs that your doctor is seeing appear to be part of the same grouping, then the likelihood that the rest of the calcs in your breast are also BC is very high.  On the other hand, if you had a discrete lump and separate from that you have an area of calcifications, it's very possible - highly likely in fact - that these calcs would not be breast cancer. 

In my case my BC was initially seen on my mammogram in the form of calcs.  These were tested and found to be BC.  When my MRI showed that my breast was full of the same stuff, it was pretty much guaranteed that it was all breast cancer.  So I had a mastectomy rather than a lumpectomy and it turns out that we were right - it was all BC (DCIS though, which is the earliest possible stage of breast cancer).

On the other hand my mammo showed calcifications in my other breast.  These were biopsied and found to be benign.  That means that these calcs won't ever turn into breast cancer.  I might get another area of calcs that is BC, but calcs that are totally benign (i.e. not breast cancer and not a high risk or pre-cancer condition like ADH or LCIS) don't become breast cancer.  So I made the decision to have a single mastectomy and in the 5 years since, my remaining breast has remained healthy (and those benign calcs are all still there).

My answer doesn't help you get closer to a decision because basically I'm saying that your calcs might be cancer or they might not be cancer.  Do you have a copy of your pathology report from your biopsy?  That would be a good place to start to understand if your diagnosis is based on calcs.  Then the question would be whether the rest of the calcs are all part of the same grouping and therefore might also be cancer. That's something that only your doctor can explain to you.  If the calcs are totally separate from your diagnosis, one option if you would prefer to have a lumpectomy is to ask for a biopsy of the calcs.  If they are totally benign then the option of having a lumpectomy would still be feasible.

anna ~ Have you already had a lumpectomy?  That's what happened to me.  I had a lumpectomy first, but unexpected pathology results from it strongly indicated that I needed a mastectomy, which I eventually had.  It was an incredible shock, and I think I actually went into shock for a few days.  I kept thinking that it must be a nightmare -- that perhaps I'd been in a car wreck on the way to my first surgeon's office, and that I was in a coma and would eventually wake up.  Seriously.  But I took time to get a second opinion (which led me to a superb medical facility & team that I switched to), and I learned about and had one of the newest types of reconstruction (Diep) that replaced my diseased breast tissue with tummy tissue for a very natural looking outcome.

So sorry it sounds like you've also had this kind of traumatic shock, but whatever you're facing, you will get through it!     Deanna

Hope the appointment with your oncologist went well, and you have a plan for action now, or at least enough information to make a good choice.

Hi Anna...

I just wanted to wish you good luck with your upcoming surgery. I know it's scary, but it will be over soon and you will be so relieved! The anticipation is far worse than the surgery! And you are young so you should bounce back quickly. I am thinking of you...

All the best,

Rose.